Volume 26, Nº 1 (2019)

The article describes the main stages of the formation of food behavior in children in the first year of life as one of the most important ways to prevent overweight and obesity in subsequent periods of life. The results of studies conducted in the Russian Federation aimed at identifying the mechanisms of early development of overweight and obesity in children and their prevention are presented. The significance of the early introduction of salt and sugar in the diet as risk factors for the formation of overweight and obesity in childhood has been established. According to the data of FRC of Nutrition and Biotechnology, salt to food is added for 41% of children of the first year of life, and by 24 months - for 85% of children. Added sugar is received by 29% of children of first year of life, and by 24 months - 72%.

The article presents the work experience of the Center for Support of Breast and Rational Feeding in the city of Tomsk. The structure of the Center, activities and staffing is described. The results of work over 10 years have been summarized: the dynamics of the prevalence of breastfeeding in Tomsk, the analysis of work of the telephone hotline, the volume of publishing activity, and the results of scientific research.

Urinary tract infection is one of the most common diseases in a pediatric population, often acquiring a relapsing course. The development of urinary tract infection and the nature of its course are determined not only by the properties of the pathogen, but also by the state of the child’s organism: in children with abnormal development of the urinary system and vesicoureteral reflux, disease often acquires a recurrent character, leading to nephrosclerosis and kidney failure. Timely diagnosis and adequate antibacterial therapy can minimize the consequences of urinary tract infections and reduce the risk of recurrence. In the treatment of urinary infection in children, in most cases preference is given to oral forms of antibiotics, among which one of the most effective is cefixime.

Background. The urgency of this problem is due to the fact that respiratory diseases occupy one of the first places in the structure of childhood morbidity. Prediction of the course and outcome of pneumonia requires timely assessment the factors responsible for the development of a severe bacterial inflammatory process. Streptococcus pneumonia remains the leading bacterial causative agent of community-acquired pneumonia (CAP) in the general population of pathogens. Objective: to determine premorbid and clinical risk factors and laboratory predictors of the development of severe pneumonia in children; to evaluate the effect of vaccination against pneumococcus on the incidence of CAP in children in Penza. Methods. Premorbid factors and clinical features of community-acquired pneumonia in 56 children were analyzed; 30 children with severe pneumonia were admitted to the intensive care unit (ICU). One of the predictors of bacterial infection is the plasma procalcitonin (PCT) level. The plasma PCT concentration (with a detection threshold of 0.5 ng/mL) was determined by a semi-quantitative immunochromatographic method for 26 hospitalized children with community-acquired pneumonia. A statistical analisis of the effect of vaccination against pneumococcus on the incidence of community-acquired pneumonia in children in Penza was also performed. Results. The influence of the nature of premorbid factors on the clinical manifestations of severe pneumonia was found, the dependence of the PCT level on the severity of the inflammatory process in the lungs was determined; and it has been proved that CAP incidence in children vaccinated with a 13-valent conjugated pneumococcal vaccine was 3.2 times lower than in unvaccinated children. Conclusion. The group of patients with pneumonia requiring intensive care in ICU is heterogeneous in the nature of the combined pathology, risk factors, severity of respiratory failure syndromes, circulatory disorders, and toxic-hypoxic damage to the central nervous system, which affects the prognosis of the disease, therapy and length of stay in the ICU. The procalcitonin test is an important predictor of severe pneumonia and the development of complications; it is most informative in pulmonary destruction or the formation of a septic process. A direct correlation between the CAP incidence and the level of vaccination against pneumococcus in the child population was found.

Objective. Evaluation of clinical features, etiology of FA in infants depending on the feeding type. Methods. 177 infants (110 boys; 67 girls) were under observation; among them 39 (22%) up to 1 year of life, 60 (33.9%) from 1 year to 2 years, and 78 (44.1%) from 2 to 3 years of life. The underlying and associated diseases were diagnosed according to the clinical and allergological examination (allergic history), analysis of the food diary and elimination-provocation tests, and allergic diagnostic test of indirect mast cell degranulation. Results. As shown by the analysis of the manifestations of the clinical symptoms, character of PA in infants depends on the feeding type. In addition to the main cause, risk factors are also of great importance in the development and formation of PA. Among them, hereditary burden (70%) prevails, with maternal inheritance 2 times more common than paternal inheritance, allergic diathesis (45.7%), focal infections (42.3%), gestational toxicosis in mothers of sick children (45.2%). Conclusion. FA in infants is clinically more often manifested in the forms of gastrointestinal allergy, allergic dermatitis and respiratory allergies. The lack of natural (breast)feeding and early mixed or artificial feeding, as well as risk factors: hereditary burden, allergic diathesis, focal infections, etc., play an important role in the development of the disease.

Therapy with modern probiotics is of particular importance in almost any acute and chronic diseases, accompanied by dysfunction of the microbiocenosis and intestinal barrier. The article presents data on the role of microbial communities in the development of irritable bowel syndrome. The need for the use of probiotics remains urgent due to their effectiveness, safety and widespread availability. The results of studies using the strain Lactobacillus rhamnosus in a variety of clinical situations are presented.

Acute respiratory infections (ARI) dominate among diseases in children; over 200 different viruses can cause them. The possibilities of antiviral therapy for ARI are limited, incl. narrow spectrum of chemotherapeutic agents. The interferon system (IFN) is the main component of antiviral immune protection against ARI pathogens. Recombinant IFN-α-based preparations are active against a wide spectrum of viruses and can be used for empirical therapy of ARI. The article assesses the effectiveness of the use of nasal and rectal forms of the recombinant IFN-α2b preparation Genferon Lite for ARI and influenza in children.

According to modern concepts, infectious mononucleosis (IM) is a polyetiological disease. Currently, it is proven that along with the Epstein-Barr virus (EBV) other viruses of the Herpesviridae family are etiologically significant causative agents of mononucleosis, and IM may be caused by one of the viruses or their combinations in various phases of the infectious process. Exanthema against the background of HHV-6 infection is associated with the development of nonspecific vasculitis, caused by the damaging effect of immune factors on the vessel wall and the endotheliotropic nature of the virus, which can manifest as a macular, maculopapular or hemorrhagic rash. In the presented clinical case, the level of viral load and the influence of risk factors for toxicodermia, but not immunological disorders, correlate with the severity and nature of skin manifestations.

Background. Vulvovaginitis (VV) ranks first in the structure of gynecological diseases of girls and adolescents. This is primarily due to the anatomical features of the structure of children’s genital organs; in addition, alkaline reaction of vaginal secretion, low glycogen content, the absence of Doderlein bacilli, low estrogen level and low immune resistance contribute to the penetration of pathogenic causative agents, leading to the VV occurrence. Description of the clinical case. A clinical case of VV in a 3-year-old girl is described. A local anti-inflammatory therapy with the drug benzydamine (Tantum® Rosa) was carried out 2 times a day for 7 days. Conclusion. Based on the results of the child’s treatment, it has been shown that Tantum® Rosa is one of the effective drugs for treating girls with VV caused by coliform bacteria and streptococci, as well as Candida fungi. The use of this drug in girls and adolescents is recommended in both outpatient and home settings in accordance with the instructions under the supervision of a specialist.